DESCRIPTION: The overall objective of this study is to develop, implement, and evaluate the effectiveness of a culture-specific, problem-based, self-management program for African Americans with diabetes. This program of clinical and psychosocial training and support is meant to complement and enhance the medical care currently being received by African Americans with diabetes. The study's two major hypotheses are that (1) patients participating in the initial problem-based, self-management training program will demonstrate greater improvement on major health related outcomes than patients randomly selected to participate in a usual care control group, and (2) patients participating in an intensive, proactive, nurse-run follow-up program will demonstrate a greater improvement on major health related outcomes than patients randomly selected to participate in a usual care control group. The study's specific aims are: 1. Develop and evaluate the efficacy of [a] culture-specific, problem-based program of diabetes self-management training for African Americans in improving health related outcomes such as blood glucose levels, blood pressure, cholesterol, psychosocial functioning, self-care behavior, quality of life, and health care costs. 2. Identify patient demographics, disease characteristics, and health beliefs that predict the efficacy of the self-management training program for different sub-groups of patients. 3. Develop and evaluate the efficacy of an intensive, proactive, nurse-run, follow-up self-management program for patients who have completed the self-management training program in improving or maintaining health related outcomes such as blood glucose levels, blood pressure, cholesterol, psychosocial functioning, self-care behavior, quality of life, and health care costs. 4. Disseminate the initial self-management training and the intensive follow-up programs nationally and provide training seminars and technical assistance to health care professionals wishing to use the self-management training and intensive follow-up programs in local settings.